HomeMy WebLinkAbout0156636-Electric (service change) � CITY OF OSHKOSH No 156636
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1316 BROAD ST Owner RUSSEL B/PATRICIA A DIENER Create Date 07/11/2013
Contractor CUMINGS ELECTRIC INC Category 634-Residential-Service Change Plan
Inspector Adam Krause
Service New 0 Change � Temp � N/A Type � Overhead 0 Underground �
Volts 120/240 Circuits Luminaires
Amps 100 Switches Receptacles
Appliances
i
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Use/Nature of SFR\replace electrical service :
Work
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Fees: Valuation $1,200.00 Plan Approval $0.00 Permit Fee Paid $87.00
Issued By: �� Date 07/11/2013
❑ Permit Voided' Parcel Id# 1507930000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the Ciry of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address PO BOX 749 NEENAH WI 54957 -749 Telephone Number (920)722-1240
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
1 11 2013 7: 25RM HP LHSERJET FRX p. l
� Divieiaa of In4pootioli B�rvice�
� 215 Church Avenue
4.0. 8ox 1130
0�}�kosh, WI 5i903�i13p
Bax (92C) 236-5094
phone 1910) 936-5046
FLECTRICAL PfiRMIT APPLICATION
All information After bold categoriee muet be pravided.
Incomplete applicabione aill not be proceeeed.
DATE 111/13
JOB ADDRESS 1316 Broad Street Joa No. C227-00
owt�R Diener. Mrs.
CONTRACTOR CUMINGS ELECTRIC INC.
CHECK ALL A'DpLICABLE
U8E CATEGORY: 6INGLE FAMILY� DUPLEX� MULTI-FAMILY❑ RENTAL�
CONlNlERCIAL❑ INDU$TRIAL�
SSRVICEe NEW � CHI�NGE � TEMPORARY ❑ NOT APPLICABLE ❑
TYPB: OL�ERHF�AD � UNAERGROUND ❑ NOT APPLICAHL� ❑
NLTMBER OF FIXTURES _ SWITCH�9 _ REC$PTACLES _ CIRCVIT9
AMP9 'IOO VOLTB 'I2� PHA$$ 'I
CHBCR ALL APPLICI►HL�
RANGE ❑ WATER NEATER ❑ GARBAQE DI3POSAL � DRYER ❑
DISHWASHER � FAN OR HLOWER � FURNACE ❑ A/C ❑
BLFiCTRIC 9IG:J ❑ MOTOR9 ❑ GAS PUMPB [] p�gR
DSSCRIPTION OF �LL WObtIC H�INp DONE Service Change
`TAL[TE (=neluding labor ar►d all mat�riala� iacluding light iixtyr��) 5�.2�4.00
P&KIEZT 11L�
�►eT$a sLSC.-rRic=a� Rlchard Wenzel
Submit payment with application. F�►ilure to pay within 30 days will reeult in
fees being dcubled or 5100. 00 plus the normal permit fee, which ever is greater.
OR
Check here �f ou want this rocesaed throu h rour account �
#100-0750-Z515-00000